Two School-Based Mental Health Services: One Systemic Approach
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Transcript of Two School-Based Mental Health Services: One Systemic Approach
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JEFF CHANG, PH.D., R.PSYCH.ASSOCIATE PROFESSOR
ATHABASCA UNIVERSITY
DIRECTOR, THE FAMILY PSYCHOLOGY CENTRE
Two School-Based Mental Health Services: One Systemic
Approach
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Two School-Based Mental Health Services: One Systemic Approach
Acknowledgements:Program funding provided by Alberta
Health Services Mental Health Capacity Building
Projects Student Health Partnership
Athabasca University Academic and Professional
Development Fund
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The Context: Calgary, AB, Canada
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Calgary, AB
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Calgary, AB
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Calgary, AB
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Foundations
Ecosystemic theory Microsystem, mesosystem, exosystem, and
macrosystemResilience literature
Relationships, connections, having a confidante Skills/interests Values
Family therapy (Kenneth Hardy) Context Relationships Interactions
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The InterSSCT (“intersect”) Model
InterfacesSystemsSkillsConnectionsTransitions
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The InterSSCT (“intersect”) Model
A heuristic for guiding program development
A template for reflective practiceA framework for case
conceptualization
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Two School-Based Mental Health Services
Family-School-System Consultation Service (Student Health Partnership) – mental health therapists providing a targeted larger systems consultation service
Wellness Empowerment Program (Mental Health Capacity Building Projects) – universal in-school mental health programming
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Family-School-System Consultation Service
Referral criteria:Students from Grades 1 to 12 in any independent
school experiencing emotional-behavioral problems, and who have exhausted the resources of their school. Referrals are accepted from the school in which the student is registered.
Purpose:
To facilitate planning, support, and implementation, to maximize school success for the student, and system responsiveness to the family.
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Family-School-System Consultation Service
What happens at the Consultation Meeting?
The Mental Health Consultant conducts a larger systems interview to:obtain their view of the problemclarify goalslist attempted solutionslearn what additional supports or services
would be considered helpful by the partners
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Family-School-System Consultation Service
ascertain what additional information (diagnosis or assessment) would be useful to the partners
make a plan, clearly specifying the contributions of the school, parents, student, FPC, and other service providers
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Family-School-System Consultation Service
The following services are available from Family School-System Consultation:follow-up Consultation Meetingsshort-term individual support to the
studentconsultation to the schooloutcome-oriented, focused counselling
for children and/or families
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Family-School-System Consultation Service
referral to speech-language therapy and/or occupational therapy
facilitation of access to medical/pediatric/psychiatric consultation services
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Family-School-System Consultation Service
Case conceptualizationInterfaces: Ensure that relationships between the
service and the schools are clear and that the mandate of the service is well understood
Are the interfaces between the school and community agencies functional?
What is quality of the interactions between the school and the family? Do they agree about how to construct the problem?
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Family-School-System Consultation Service
Systems What are the formal rules (policy and
procedures) of systems (school division, mental health, child protection)?
What are the informal rules of the system (organizational culture) of the school and the family?
Skills What are the proactive and prosocial skills of
the various individuals in the system? Are there skill deficits? What is the readiness for change?
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Family-School-System Consultation Service
Connections What are the positive relationships in the system? Can existing connections support the
interventions (stages of change/working alliance) What relationships need to be built up and
enhanced?Transitions How do the school and family handle within-day,
day-to-day and week-to-week transitions? How do they manage the rhythm of the school
year? How do they manage Family Life Cycle and
developmental transitions?
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Universal Mental Health Programming in Schools
• On one hand, health, including mental health is not the core business of schools, with the exception of legislated mandates related to identified students with disabilities.
On the other hand, the whole school mental health literature notes:schools are the only point of close-to
universal access to young people young people spend close to half their
waking hours in school
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Universal Mental Health Programming in Schools
the quality of experiences with teachers and peers affect emotional wellbeing
transitions in education are significant events in the lives of younger adolescents. The transition from primary school to secondary school brings a loss of continuity in relationships (teachers and peers).
Schools provide an entry point to the family
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Universal Mental Health Programming in Schools
Exemplary whole school programs: MindMatters and Gatehouse Program (Australia)
The latter uses attachment theory as a conceptual framework: “The extent to which an individual has robust social ties is likely to have a direct influence on self-concept and sense of belonging, and, in turn, reactions to social stressors.”
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Universal Mental Health Programming in Schools
Whole school programming: Avoids piecemeal ‘add-ons.’ Many
school-based interventions take a single-issue focus with short-lived support.
These are perceived as extras and remain in fragmented pockets in the school.
such health initiatives are perceived as increasing the workload and stress of teachers.
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Universal Mental Health Programming in Schools
supports sustainable and institutionalized practices
Three school functions, structures and culture:(i) school social and learning
environmentsa) Whole schoolb) Classroom
(ii) content and implementation of school curriculum
(iii)the linkage between the school and its community.
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Universal Mental Health Programming in Schools
Although direct counselling services are part of universal programming, they are de-emphasized.
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The Wellness Empowerment Program
A universal mental health program for two schools serving Muslim students in Calgary
70,000-strong Muslim community in CalgaryFunded by Alberta Health Services Mental
Health Capacity Building fund
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The Wellness Empowerment Program
A publicly funded, ESL charter schoolElementary and Middle School Campus
with about 650 students
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The Wellness Empowerment Program
Calgary Islamic School: Private religious school
K-12 on one campus (650 kids)
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Interfaces
“Points of connection between systems”
As a service provider, our first point of connection was to make sure we knew what the schools wanted and needUndertook a one year development
process using ideas from Appreciative Inquiry
Collaborating with the Muslim Council of Calgary
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Interfaces
Linking the schools with:Child protection authoritiesAlcohol and drug treatment agency
(for information sessions) Other schoolsCalgary Police Service
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Interfaces
Health care system Domestic violence services
Connecting children with Islamically appropriate recreational opportunities
What other interfaces to we need to strengthen?
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Systems
“Understanding and fitting in with the mandate, rules, and communication style of systems you are serving”
“Acting as a bridge between systems to ensure they interface properly”
One the interface is built, it needs to be serviced
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Systems
A Grade 3 girl, who had not spoken in school since ECS, was referred to the WEP team. We supported a referral to a specialized clinic at Alberta Children’s Hospital, where a clinical psychologist devised a behavioral shaping
program to reinforce the girl for speaking in tiny increments. The worker supported the mother,
the teacher, and the child to implement the program over the school year, with at least 83
contacts with the girl, who is still quiet, but has given oral presentation to her class.
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Systems
“Thank you for helping me with doctor’s appointments. It’s good to know that this
type of support is in the school.” -Parent
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Skills
“Supporting skills and competencies for all members of the school community”
A combination of skills geared to “mental health issues” and life in general
Resiliency literature supports to idea that when people are more competent across domains, they are more protected from poor mental health outcomesConnections“Ensuring that everyone has a place to go in a
safe and caring school”
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Supporting Skills and Connections
Activities:Whole-school activities (e.g., Wellness Day)Parent activities (e.g., parenting workshops,
internet safety)Whole-class activities (presentations on
organizational skills, dealing with emotions, bullying)
Targeted group activities (shyness group, girls’ group)
Specific supportive counselling to identified students
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Example: Weekly Lunchtime Skill-Building Groups
Anger
Management
Relational
Aggression
Leadership
Girls GroupShyness
Boys Group
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- A discussion poster from the Relational Aggression group
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Small Group Skill Building64 students have participated in
weekly lunch-time skill building groups across 3 schools
“ This group really helped me a lot and gave me lots of ideas and tips…” - Student
“I liked how group is not taught in a text book-ish way - it's done in a fun way.”-Student
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Classroom Presentations
Over 35 different topics: peer relationships safety academic skills personal development problem-solving bullying and respectful relationships multiple intelligences emotional regulation Etc., etc., etc.
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“I never knew what cyber bullying was until your presentation. It has been
going on for 1 year now and I need help.”
- Gr. 6 student
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Kindergarten-Junior High Leadership Program
Grades 6, 7 and 9 students volunteer for 6 week blocks to provide leadership activities for Kindergarten students during recess. Initially, in October 2008, 4 leaders From September ’09- Jan ‘10, 64 leaders
Teachers report that playground problems have decreased
Positive relationships between Kindergarten and Junior High students
Leaders demonstrate increased maturity and responsibility outside of volunteering time
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Case Example: The Re-Connect Booth
Grade 5 students did not seem to have the necessary conflict resolution skills
Students were going to either their homeroom teacher or the School Support Counsellor to have their disagreements, miscommunication and misunderstanding "solved“
To teach the students how to use the booth, which was set up in a corner of the classroom, the School Support Counsellor delivered a presentation to the class on basic communications skills: The acronym is C.A.R.E.
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Case Example: The Re-Connect Booth
C=Conflict is happening, address it! A= Active Listening . Students meet together at
the booth and practice active listening skills R = Reflect and Make a Plan. Brainstorm 3
possible solutions to the problem, and agree on which solution they would like to try first).
E = Evaluate. 2-3 days laterChildren have been actively using the
booth as a location to deal with day to day social difficulties
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Environmental/Leadership Program
Nineteen Grade 9 and 10 students:o Green initiativeso Service at school eventso First aid and CPR trainingo Outdoor pursuitso Peer conflict resolutiono Encouraged by Imam
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Transitions
“Navigating typical and unexpected changes in schools, physical environment, and relationships
Requested by schools at start of project
Supporting student transitions... Into ECS ECS to Grade 1 Grade 5 to Grade 6 Grade 9 to High School
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Annual Transition Activities
Half-day Grade One and Grade 6 orientations for ECS and Grade 5 students
“Thanks again, the orientation was a wonderful idea and must become an annual event. I just wish I could have thought of it!”
-Teacher
“It was extremely positive and reassuring. They are excited to go into grade six!”
-Teacher
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Grade 6 orientation…
“I wish we had this when I was going into grade 6. We were just thrown into junior high and figured it out ourselves!”
–Student
“This is so cool! I’m so glad I know how to open my lock and read my timetable before I get to the junior high. It’s not that scary anymore.”
-Student
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School Bus Program
• Initial driver comments: “This program will never work, nothing will change.”• Now…. “I have some of the best kids
on the bus!”
“Lots of changes…“Getting better!”
• Significant improvement in driver retention
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“When I grow up, I want to be a School Counsellor just like the one in our
school, so that I can help kids with their problems.”
-Student’s writing in the year book
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Conclusion
Whole school or universal mental health programming has the potential to change the culture of a school
Counsellors can maximize their influenceVery little ‘counselling” may be done, but
counsellors have a key role in developing and leading programming.
Whole school mental health programming sets the stage for effective therapy, when it is needed.
Cross-cultural service delivery requires more than just learning about “the other.” It requires attention to the world view of the community and appreciation of one’s own culture and privilege.